Impact of COVID-19 outbreak on acute gallbladder disease in the emergency department
Objective Acute gallbladder disease (AGD) is frequent in the emergency department (ED) and usually requires emergency surgery. However, only a few studies have reported the impact of COVID-19 on AGD. The goal of this study was to evaluate the time between symptom onset and surgery and the perioperat...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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The Korean Society of Emergency Medicine
2023-03-01
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| Series: | Clinical and Experimental Emergency Medicine |
| Subjects: | |
| Online Access: | http://www.ceemjournal.org/upload/pdf/ceem-22-239.pdf |
| _version_ | 1797845646320861184 |
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| author | Dal Sakong Michael Sung Pil Choe Woo Young Nho Chang Won Park |
| author_facet | Dal Sakong Michael Sung Pil Choe Woo Young Nho Chang Won Park |
| author_sort | Dal Sakong |
| collection | DOAJ |
| description | Objective Acute gallbladder disease (AGD) is frequent in the emergency department (ED) and usually requires emergency surgery. However, only a few studies have reported the impact of COVID-19 on AGD. The goal of this study was to evaluate the time between symptom onset and surgery and the perioperative severity of AGD during the COVID-19 pandemic compared to before the era of COVID-19. Methods This retrospective, single-center cohort study included patients who presented to the ED with suspected AGD and who underwent emergency cholecystectomy. We designed a before-after comparative study, and the intervention was the COVID-19 outbreak. The 6-month period after the COVID-19 outbreak was defined as the post-COVID group, whereas the pre-COVID group consisted of the same period in the previous year. The primary outcome was the time from symptoms to surgery. We evaluated the time intervals between symptom onset and ED arrival and between ED arrival and surgery. The secondary outcomes were preoperative and postoperative severity indexes. Results A total of 316 patients was analyzed. The post-COVID group showed longer duration from symptom onset to ED arrival (34.0 hours vs. 15.0 hours, P<0.001) and longer time interval from ED arrival to surgery (16.2 hours vs. 10.2 hours, P<0.001) than the pre-COVID group. The overall time interval between symptom onset to surgery was longer in the post-COVID group than the pre-COVID group (71.5 hours vs. 33.5 hours, P<0.001). The post-COVID group showed higher preoperative Simplified Acute Physiology Score II scores than the pre-COVID group (20.1 vs. 18.2, P=0.045). The proportion of moderate or severe disease increased in the post-COVID group (78% vs. 65%, P=0.017). The durations of hospital stay (7.0 days vs. 5.0 days, P<0.001) and intensive care unit stay (27.1 hours vs. 10.8 hours, P=0.008) were longer in the post-COVID group than in the pre-COVID group. Conclusion During the pandemic, the time interval between symptom onset to surgery was significantly increased among patients with AGD. Concomitantly, higher preoperative severity indexes and longer hospital stay were reported with a delay in emergency surgery. |
| first_indexed | 2024-04-09T17:42:22Z |
| format | Article |
| id | doaj.art-ff6eba0c6512454881aa8739c4e3dc92 |
| institution | Directory Open Access Journal |
| issn | 2383-4625 |
| language | English |
| last_indexed | 2024-04-09T17:42:22Z |
| publishDate | 2023-03-01 |
| publisher | The Korean Society of Emergency Medicine |
| record_format | Article |
| series | Clinical and Experimental Emergency Medicine |
| spelling | doaj.art-ff6eba0c6512454881aa8739c4e3dc922023-04-17T04:26:52ZengThe Korean Society of Emergency MedicineClinical and Experimental Emergency Medicine2383-46252023-03-01101849110.15441/ceem.22.239437Impact of COVID-19 outbreak on acute gallbladder disease in the emergency departmentDal Sakong0Michael Sung Pil Choe1Woo Young Nho2Chang Won Park3 Department of Emergency Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea Department of Emergency Medicine, CHA Gumi Medical Center, CHA University School of Medicine, Gumi, Korea Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea Department of Emergency Medicine, Daegu Fatima Hospital, Daegu, KoreaObjective Acute gallbladder disease (AGD) is frequent in the emergency department (ED) and usually requires emergency surgery. However, only a few studies have reported the impact of COVID-19 on AGD. The goal of this study was to evaluate the time between symptom onset and surgery and the perioperative severity of AGD during the COVID-19 pandemic compared to before the era of COVID-19. Methods This retrospective, single-center cohort study included patients who presented to the ED with suspected AGD and who underwent emergency cholecystectomy. We designed a before-after comparative study, and the intervention was the COVID-19 outbreak. The 6-month period after the COVID-19 outbreak was defined as the post-COVID group, whereas the pre-COVID group consisted of the same period in the previous year. The primary outcome was the time from symptoms to surgery. We evaluated the time intervals between symptom onset and ED arrival and between ED arrival and surgery. The secondary outcomes were preoperative and postoperative severity indexes. Results A total of 316 patients was analyzed. The post-COVID group showed longer duration from symptom onset to ED arrival (34.0 hours vs. 15.0 hours, P<0.001) and longer time interval from ED arrival to surgery (16.2 hours vs. 10.2 hours, P<0.001) than the pre-COVID group. The overall time interval between symptom onset to surgery was longer in the post-COVID group than the pre-COVID group (71.5 hours vs. 33.5 hours, P<0.001). The post-COVID group showed higher preoperative Simplified Acute Physiology Score II scores than the pre-COVID group (20.1 vs. 18.2, P=0.045). The proportion of moderate or severe disease increased in the post-COVID group (78% vs. 65%, P=0.017). The durations of hospital stay (7.0 days vs. 5.0 days, P<0.001) and intensive care unit stay (27.1 hours vs. 10.8 hours, P=0.008) were longer in the post-COVID group than in the pre-COVID group. Conclusion During the pandemic, the time interval between symptom onset to surgery was significantly increased among patients with AGD. Concomitantly, higher preoperative severity indexes and longer hospital stay were reported with a delay in emergency surgery.http://www.ceemjournal.org/upload/pdf/ceem-22-239.pdfacute cholecystitiscovid-19pandemicscholecystectomy |
| spellingShingle | Dal Sakong Michael Sung Pil Choe Woo Young Nho Chang Won Park Impact of COVID-19 outbreak on acute gallbladder disease in the emergency department Clinical and Experimental Emergency Medicine acute cholecystitis covid-19 pandemics cholecystectomy |
| title | Impact of COVID-19 outbreak on acute gallbladder disease in the emergency department |
| title_full | Impact of COVID-19 outbreak on acute gallbladder disease in the emergency department |
| title_fullStr | Impact of COVID-19 outbreak on acute gallbladder disease in the emergency department |
| title_full_unstemmed | Impact of COVID-19 outbreak on acute gallbladder disease in the emergency department |
| title_short | Impact of COVID-19 outbreak on acute gallbladder disease in the emergency department |
| title_sort | impact of covid 19 outbreak on acute gallbladder disease in the emergency department |
| topic | acute cholecystitis covid-19 pandemics cholecystectomy |
| url | http://www.ceemjournal.org/upload/pdf/ceem-22-239.pdf |
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